Unraveling the Intricate Roles of Exosomes in Cardiovascular Diseases: A Comprehensive Review of Physiological Significance and Pathological Implications

Abstract

Exosomes, as potent intercellular communication tools, have garnered significant attention due to their unique cargo-carrying capabilities, which enable them to influence diverse physiological and pathological functions. Extensive research has illuminated the biogenesis, secretion, and functions of exosomes. These vesicles are secreted by cells in different states, exerting either protective or harmful biological functions. Emerging evidence highlights their role in cardiovascular disease (CVD) by mediating comprehensive interactions among diverse cell types. This review delves into the significant impacts of exosomes on CVD under stress and disease conditions, including coronary artery disease (CAD), myocardial infarction, heart failure, and other cardiomyopathies. Focusing on the cellular signaling and mechanisms, we explore how exosomes mediate multifaceted interactions, particularly contributing to endothelial dysfunction, oxidative stress, and apoptosis in CVD pathogenesis. Additionally, exosomes show great promise as biomarkers, reflecting differential expressions of NcRNAs (miRNAs, lncRNAs, and circRNAs), and as therapeutic carriers for targeted CVD treatment. However, the specific regulatory mechanisms governing exosomes in CVD remain incomplete, necessitating further exploration of their characteristics and roles in various CVD-related contexts. This comprehensive review aims to provide novel insights into the biological implications of exosomes in CVD and offer innovative perspectives on the diagnosis and treatment of CVD.

Laminin Alpha 2 Enhances the Protective Effect of Exosomes on Human iPSC-Derived Cardiomyocytes in an In Vitro Ischemia-Reoxygenation Model

“…Although we observed similar results in ECs under all EXO treatments, our data demonstrate an enhanced protective effect of LAMA2-EXOs in cardiomyocytes, mainly after 1.5 h of reoxygenation compared to untreated cells; LAMA2-EXO treatment resulted in cells reaching baseline values more quickly than those treated with gel-EXOs. EXOs have anti-apoptotic characteristics, and this protection has been previously studied [49]. Similar to our findings, a recent study demonstrated a protective effect of EXOs, with a 60% decrease in apoptosis in cardiomyocytes under ischemia-reperfusion injury [50].…”

Stem Cell Therapy against Ischemic Heart Disease

“…The observed stem-cell-mediated benefits have been shown to be attributable to the paracrine functions of stem cells. In this aspect, exosomes appear to play a key role, particularly because of their contents of microRNAs, which have been found to be of great clinical potential in the treatment of ischemic heart disease [118,144,[191][192][193]. Taking into account the limited availability of autologous stem cells, exosomes from their allogeneic and xenogeneic counterparts may also offer significant therapeutic advantages [104].…”